Hi -

Has anyone used 400 mg of Provigil? I've been on 200 mg for about 10 days but haven't seen any improvement. My doctor wants me to take 400 mg a day (200 mg twice a day). I take 150 mg of Zoloft for depression and anxiety...it's not working especially well, but my PCP wanted to wait and see what the latest sleep study showed before increasing the dosage or switching to another medicine. I'm wondering if the Provigil isn't working because of the depression. I've used a CPAP/CLEX for almost 3 years...I had a sleep study done at a lab about 3 weeks ago and the results confirm that the apnea is being successfully treated. During the nap study, I fell asleep in less than 4 minutes all 4 times.

Any and all feedback is greatly appreciated!

winstonpepper wrote:

Hi -

Has anyone used 400 mg of Provigil? I've been on 200 mg for about 10 days but haven't seen any improvement. My doctor wants me to take 400 mg a day (200 mg twice a day). I take 150 mg of Zoloft for depression and anxiety...it's not working especially well, but my PCP wanted to wait and see what the latest sleep study showed before increasing the dosage or switching to another medicine. I'm wondering if the Provigil isn't working because of the depression. I've used a CPAP/CLEX for almost 3 years...I had a sleep study done at a lab about 3 weeks ago and the results confirm that the apnea is being successfully treated. During the nap study, I fell asleep in less than 4 minutes all 4 times.

Any and all feedback is greatly appreciated!

Hi Winstonpepper

Provigil is a stimulant and while I am not up to speed on dosages, to double your dose seems extreme. Provigil was used during the Gulf War by the Pentagon to keep pilots alert. It was reported that they could keep fighter/bomber pilots alert for up to 35 hours...........God knows what mess they were in afterwards. There has been talk of addiction problems, but nothing concrete. Probably over a longer period.

Your recent study shows that the apnoea is being treated, yet you have EDS.........strange enough. Is there a possibility that you have another condition, creeping in ? Any other symptoms ?

Daniel


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

Daniel - Thanks for your reply.  Maybe the EDS is just the way I am...I've been a low energy person my whole life...napping whenever possible.  I do have headaches...there are many possible causes - clenching (I can't wear a nightguard right now and spend all night clenching my teeth - however, this didn't affect my sleep), allergies, stress, depression, possibly starting menopause.  I like my sleep doctor and he's usually been pretty conservative/middle-of-the-road.  When I asked him what would happen if 400 mg. doesn't work, he said we could try other, more traditional stimulants like Ritalin.  Can't decide what to do and am feeling pretty discouraged about the whole thing.  WinstonPepper

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Last edited by another_guest on Tue Oct 31, 2006 10:58 pm; edited 1 time in total

Wow this is weird.  Ok, maybe not weird so much as more common than I thought.  I have been put on Provigil 200 as of a week ago, after having my MSLT where my average was ~4 minutes as well.  

However I have found mixed results: some days my daytime sleepiness is just as bad as previously, while other days it's almost non-existant.  I can say my depression/anxiety have all but disapeared, but it has only been a week, time will tell.

Good luck!

Oh and by the way, a really good search engine is:  www.google.com/unclesam
This limits the results to .gov .nih .mil .etc

another_guest:

Thanks for your message.  I've decided to stop taking the Provigil altogether for now.  I'm going to work on eating better and exercising, and hope these things help.  I'd also like to stop taking the Zoloft...am feeling kind of overmedicated right now.

airfieldman:

Thanks also for your message...I guess we're sort of kindred spririts.  I'm glad to hear you've gotten some relief with the Provigil....hope it continues and good luck with the journal.

WinstonPepper

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Last edited by another_guest on Tue Oct 31, 2006 10:58 pm; edited 1 time in total

Hi WinstonPepper:
During your sleep study from 3 weeks ago, were you on CPAP for the overnight study, and for that matter, on CPAP for the ensuing nap (MSLT) study?
A mean sleep latency of less than 5 minutes during the MSLT denotes pathological sleepiness, and this is especially significant if it occurs during effective CPAP use.
I agree with A_G, discuss these medication changes with your physician first, you can't just leave a 4 minute mean sleep latency hanging out there, and suddenly stopping Zoloft could create some untoward effects as well.
Do you have the results from your sleep study, including sleep stage percentages, arousals, total sleep time?  Any other pertinent medical history?  Any chance of getting the sleep architecture graph?
Write back.
sleepydave

Hi -

another_guest:  Thanks for your follow-up...not to worry, I'm a very compliant patient and would never stop a medication without talking to the doctor first.  Went through the whole skin testing for allergies and am scheduled to start the injections in a week or so.

sleepydave:  I was on CPAP for both the overnight and daytime studies...I'll ask for a copy of the results on Monday and let you know...can't think of any other relevant medical history, but it's late and I'm about to crash.

Thanks!

WinstonPepper

another_guest wrote:

Several years ago I was given provigil as an adjunct to the antidepressant I was on - was told there had been studies of using them together to treat depression.  At that time I was able to find a couple references using a search engine.  You might check to see if there are reputable medical sites on this.

Personally I couldn't handle the provigil at even low doses since it played havoc with my heart.  

How much do you think the zoloft (or other meds or even your allergies) is/are sedating you because to me it seems that you don't want to take another med to counter side effects of one if there is a better solution out there?

I wanted to know if provigil caused an increase in your heart rate?  I would like something to help combate EDS as I am just getting started on cpap, but can't take anything that would increase my heart rate.

dillmom:  I for one have not noticed any change in my heart rate, nor my blood pressure.

dillmom wrote:

another_guest wrote:

Several years ago I was given provigil as an adjunct to the antidepressant I was on - was told there had been studies of using them together to treat depression.  At that time I was able to find a couple references using a search engine.  You might check to see if there are reputable medical sites on this.

Personally I couldn't handle the provigil at even low doses since it played havoc with my heart.  

How much do you think the zoloft (or other meds or even your allergies) is/are sedating you because to me it seems that you don't want to take another med to counter side effects of one if there is a better solution out there?

I wanted to know if provigil caused an increase in your heart rate?  I would like something to help combate EDS as I am just getting started on cpap, but can't take anything that would increase my heart rate.

I have pasted some of the Q & A's from the provigil website.

I think you should keep in close contact with your doctor.

Daniel

 Q:
    
    Will I have side effects after taking PROVIGIL?

A:
    
    PROVIGIL is generally well tolerated. However, PROVIGIL can cause side effects in some people. When side effects do occur with PROVIGIL, they are generally mild to moderate in nature.

The most common side effects of PROVIGIL are headache, nausea, nervousness, stuffy nose, diarrhea, back pain, anxiety, trouble sleeping, dizziness, and upset stomach. PROVIGIL may cause the following infrequent serious side effects. Call your doctor or get emergency help if you have any of these or any other serious side effects while taking PROVIGIL:

    * Chest pain
    * Mental problems
    * Allergic reactions such as a rash or hives, or other allergic reaction

Tell your doctor if you have any side effects while taking PROVIGIL. These are not all the side effects of PROVIGIL. For more information, ask your doctor or pharmacist.


Q:
    
    Can I become addicted to PROVIGIL?

A:
    
    PROVIGIL is a controlled substance [C-IV]. This means that PROVIGIL may be a target for people who abuse medicines or street drugs. Keep your PROVIGIL in a safe place. Giving your prescription of PROVIGIL to anyone is against the law.

Some effects of PROVIGIL on the brain are similar to other medications called ""stimulants."" If you have a history of drug and/or stimulant use or abuse you should discuss this with your doctor before starting PROVIGIL.


Q:
    
    Can I take other medications at the same time as PROVIGIL?

A:
    
    PROVIGIL and many other medicines may interact with each other, causing side effects. PROVIGIL may affect the way other medicines work and other medicines may affect how PROVIGIL works. Keep a list of all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Share this list with your doctor. Your doctor or pharmacist can tell you if it is safe to take PROVIGIL and other medicines together. You should avoid drinking alcohol while you are taking PROVIGIL.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

....



Last edited by another_guest on Tue Oct 31, 2006 10:56 pm; edited 1 time in total

sleepydave wrote:

Hi WinstonPepper:
During your sleep study from 3 weeks ago, were you on CPAP for the overnight study, and for that matter, on CPAP for the ensuing nap (MSLT) study?
A mean sleep latency of less than 5 minutes during the MSLT denotes pathological sleepiness, and this is especially significant if it occurs during effective CPAP use.
I agree with A_G, discuss these medication changes with your physician first, you can't just leave a 4 minute mean sleep latency hanging out there, and suddenly stopping Zoloft could create some untoward effects as well.
Do you have the results from your sleep study, including sleep stage percentages, arousals, total sleep time?  Any other pertinent medical history?  Any chance of getting the sleep architecture graph?
Write back.
sleepydave

Hi - I just got results from the sleep center...for the overnight, the total sleep time was 492 minutes, sleep latency was normal at 12.4 minutes and REM latency was prolonged at 330.5 minutes...absent Delta sleep...for the MSLT, the mean sleep latency was abnormally brief at 3.8 minutes...no REM sleep was observed during any of the 4 naps.

During the MSLT, the onset to sleep times were: 0.9, 2.5, 5.5 and 6.4...

For the overnight, the sleep stage percentages were:  Stage 1 - 5.8%, State 2 - 74.8%, Stage 3 - 0%, Stage 4 - 0%, Stage REM - 19.4%

Spontaneous arousals were:  total events (index -3.0; total - 25), NREM (index - 3.8; total - 25); REM - zero

Also, there were "clusters of periodic limb movements unrelated to disordered breathing events...overall PLM index was 25.6 movements per hour and the PLM arousal index was 4.3 movements per hour of sleep"

I have 6 graphs...sleep staging, oxygen saturation, respiratory events, cpap, limb movements, body position...which one of these would be "sleep architecture"?

Please let me know what you make of all this....thanks!  WinstonPepper

Hi wp:
REM latency of 330 minutes, huh?  Zoloft strikes again.

The sleep architecture is the sleep stages, but if you can put them all up, they're always interesting to see.  The limb movements one, especially, curious about that.

Any other medications?  Other medical history?  Something like neurological events, including head injury or stuff like that.  Also the respiratory events, we need to see the total number of arousals.

BTW, how old are you, PM if you want.  Zero is kinda low for Stage 3/4 sleep, that's gonna need some sort of explanation.

sleepydave